Hypertrophic Obstructive Cardiomyopathy + Other CMs Flashcards
What are cardiomyopathies?
Disorders of the heart muscle
What is hypertrophic obstructive cardiomyopathy?
Condition where the LV becomes hypertrophic > blocks blood flow out of LV
Left ventricular outflow tract obstruction
Autosomal dominant
What inheritance if hypertrophic obstructive cardiomyopathy?
Autosomal dominant
Defect in genes for sarcomere proteins
What increased risks are assocaited with HOCM?
- heart failure
- MI
- arrhythmias e.g. AF
- sudden cardiac death
What is a notable cause of sudden cardiac death in young people?
Hypertrophic obstructive cardiomyopathy
Presentation of hypertrophic obstructive cardiomyopathy
- most asymptomatic
- non specific symptoms that can come on with exertion;
- SOB
- fatigue
- dizziness
- chest pain
- palpitations
- symptoms of heart failure in severe cases
Examination findings of HOCM
- ejection systolic murmur in lower left sternal border
- 4th heart sound
- thrill at lower left sternal border
- if present, signs of: AF (irregularly irregular pulse), mitral regurgitation (high pitched, pan systolic murmur) + heart failure
Investigations of HOCM
- ECG - LV hypertrophy
- echo or cardiac MRI - diagnosis
- genetic testing
Diagnosis of HOCM?
Echo or cardiac MRI
Management of HOCM
- avoid intense exercise, heavy lifting + dehydration
- beta blockers
- surgical myectomy (remove part of obstructive tissue)
- alcohol septal ablation (to shrink obstructive tissue)
- implantable cardioverted defibrillator
- heart transplant
- avoid ACEi + nitrates
What drugs should be avoided in HOCM + why?
ACEi + nitrates
Can worsen LV outflow tract obstruction
Complications of HOCM
- heart failure
- MI
- arrhythmias e.g. AF
- mitral regurgitation
- sudden cardiac death
What is alcohol induced cardiomyopathy/
Type of dilated cardiomyopathy due to long term alcohol use
What is restrictive cardiomyopathy?
Heart muscle becomes stiff + rigid
Causes impaired Ventricluar filling during diastole
What is arrhytmogenic cardiomyopathy?
Genetic condition where the heart muscle is progressively replaced by fibrofatty tissue
What is Takotsubo cardiomyopathy?
condition of rapid onset LV dysfunction + weakness
Follows severe emotional distress
broken heart syndrome
